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It’s monsoon, watch your step

Posted June 13th, 2018, 10:11 AM IST

It’s monsoon, watch your step

The monsoons bring relief from the scorching heat of the summer. However, it has dangers as well, especially in the form of diseases like dengue, leptospirosis, malaria and infectious bacteria and viruses that become active due to the high humidity. The damp weather provides the breeding ground for many diseases. Our body’s immunity is comparatively reduced. As a result, we become more susceptible to various health problems with the onset of monsoons. Every monsoon season, the risk of catching various diseases is extremely high due to unhygienic conditions and not adhering to basic preventive measures. Most of the water-borne diseases are caused by lack of hygiene and awareness about how to store food and water in a hygienic manner. A sudden drop in temperature influences one’s health, especially of those, who are allergic to cold, or who are asthmatic or diabetic. Dampness in the air promotes the growth of fungus that may be inhaled and can cause pneumonia. Children with a weak immune system are prone to several viral infections. The risk of developing mumps, measles, sore throat and the common cold in children is high during this season. Many diseases are preventable and can be dealt at home with doctor’s guidance. Some require proper medical attention; otherwise, they can become fatal.

Malaria
A one-celled parasite, called Plasmodium, causes the disease spread by female Anopheles mosquito. The most common organism causing malaria is Plasmodium vivax. However, most deaths are caused by Plasmodium falciparum. It causes the most dangerous type known as Cerebral malaria. It is characterised by fever, body ache, chills, and sweating. If untreated, it can lead to complications like jaundice, severe anaemia or even liver and kidney failure; ultimately death happens. Malaria is typically diagnosed by the microscopic examination of blood using blood films, or with antigen-based rapid diagnostic tests.




Dengue
The fever is a disease caused by viruses that are transmitted by mosquitoes (Aedes aegypti). It typically bites early in the morning. Symptoms of dengue fever include severe joint and muscle pain, headache, fever, exhaustion, and rash. Complication of dengue fever is called Dengue haemorrhagic fever. It is a specific syndrome that tends to affect young children. This complication of dengue causes abdominal pain, haemorrhage (bleeding), and circulatory collapse (shock). There is no specific antiviral medication to treat it. Rest and fluid intake are important. Pain relievers should only be taken under a doctor's supervision because of the possibility of worsening bleeding complications. Platelet count should be monitored through the course of the illness.

Chikungunya
This disease is transmitted through the bite of an Aedes mosquito which breeds in dirty or stagnated water. This mosquito can bite you not only at night but also during the day. Joint pains and fever are two most common symptoms. As Malaria, Dengue and Chikungunya are mosquito-borne measures must be taken to prevent mosquito bites. Wear full sleeve clothing if possible. Application of anti-repellant mosquito creams is helpful. Electronic mosquito repellent devices can be used during the monsoon season. Accumulation of dirty water must be kept in check to prevent mosquito breeding. Insecticide-treated mosquito nets and indoor residual spraying have been shown to be highly effective in preventing dengue and malaria. Cover water drums and water pails at all times
to prevent mosquitoes from breeding. Replace water in flower vases once a week. Clean all water containers once a week. Scrub the sides thoroughly to remove sticking mosquitoes eggs. Clean gutters of leaves and debris so that rainwater will not collect as breeding places for mosquitoes. Puncture or cut old tires used as roof support to avoid accumulation of water. Collect and dispose of all unusable tin cans, jars, bottles and other items that can collect and hold water.

Typhoid
Caused by the bacterium Salmonella typhi, which is transmitted by consuming food or water contaminated with faeces from an infected person. Poor sanitation and contaminated drinking water, direct contact with infected person's urine are other causes of the spread of typhoid. Typhoid signs and symptoms develop gradually, 1-3 weeks after exposure to the disease. Symptoms include fever, headache, weakness and fatigue, abdominal pain and diarrhoea or constipation. Preventive measures for avoiding the contraction of typhoid include washing hands well. Avoiding untreated drinking water; have cooked food only; avoid raw food.

Cholera
This is a common and deadly bacterial disease that spreads during the monsoon. This disease is caused by Vibrio cholerae found in contaminated food and water. Common symptoms include severe diarrhoea with watery stool and vomiting. This can cause rapid water loss and muscle cramps. Diarrhoea can be so acute that it leads, within hours, to severe dehydration and electrolyte imbalance. Cholera requires immediate treatment because the disease can cause death within hours. The goal is to replace lost fluids and electrolytes using a simple rehydration solution, oral rehydration salts (ORS). The ORS solution is available as a powder that can be reconstituted in boiled or bottled water. Preventive measures include providing clean drinking water, better sanitation, and better handwashing.



Hepatitis A
It is a highly contagious liver infection caused by the Hepatitis A virus. It is a waterborne viral infection. Generally caused by drinking water or food contaminated with the stool of the infected. It can spread through flies. Eating fruits, vegetables, or other foods that were contaminated during handling can cause the spread of infection. Symptoms include jaundice (yellow eyes and skin, dark urine), stomach pain, loss of appetite, nausea, fever and diarrhoea. Blood tests are used to detect its presence in the body. Practising good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Leptospirosis
A bacterial infection transmitted when urine and faeces of infected animals such as rodents, contaminate the soil, water, and vegetation. It is transmitted through contact with infected soil or water, by ingesting contaminated food or water, from the urine of an infected animal, through broken skin and mucous membrane (eyes, nose, sinuses, and mouth) contact with the contaminated water or soil. Wear leather boots or any closed shoe while stepping out of your home to allow minimum contact with contaminated soil or water. Any cuts or bruises should be treated immediately so that broken skin does not become the cause for getting infected. Few measures to prevent the above water-borne infections include the following. Drink safe and clean water only. If unsure, boil drinking water (upon reaching boiling point, extend boiling for three or more minutes). Clean your salads and leafy vegetables under running water. It is the best way to get rid of germs. Soaking the greens in salt water for about ten minutes can help remove them. Eat only freshly cooked food. Keep food away from insects and rats by covering it. Wash and cook food properly. Avoid eating unclean street food. Dispose of human waste properly. Use the toilet properly and clean it every day. Wash hands with soap and water after using the toilet and before eating. Keep surroundings clean to prevent flies, other insects and rodents from breeding. Avoid swimming or wading in flood water. Drain potentially contaminated water. Control rodents in the household. Maintain cleanliness.



Influenza (cold & flu)
Common cold is one of the most commonly occurring infections in the season. It is highly contagious disease due to the spread of virus in the air. It infects the upper respiratory tract; the nose and the throat. Symptoms include running or stuffy nose, body ache, throat irritation and soreness and fever. The best way to prevent common cold is to have a healthy, balanced and nutritious diet which will develop the immune system of the body and improve the body resistance. During monsoon, special attention is required to prevent the fungal infection of the feet. Keep them dry. Opt for open shoes during hot and humid days. Do not wear wet clothes for long. People with diabetes should not walk barefoot since the soil on which they walk is a reservoir of all types of germs. Patients with Cardiac diseases and chronic kidney diseases tend to get fluid overloaded. They are usually advised to restrict fluid intake. During summer, as they sweat a lot, the fluid restriction is relaxed a bit. However, once monsoon sets in and the heat reduced, they have to be more strict with fluid restriction. Otherwise, they tend to develop fluid overload suddenly and can have severe breathing problems that can turn fatal.

Road Accidents
The arrival of monsoon increases accidents because of wet roads. Do not take your car out 'just like another day' under slippery road conditions. If not urgent, refrain yourself from getting into the heavy rains. Usually during heavy rains, the visibility tends to become low, which makes it hard to see an oncoming vehicle. Hence it is better to keep the car headlights switched on. In wet conditions, it is also better to turn off the cruise control mode. Keeping a safe distance from the vehicle in front is always significant in any conditions. However, during rains, it is recommended to keep a more than 'safe' distance between vehicles as there are chances of skidding during emergency braking. Taking swift turns on a wet surface causes tyres to skid, resulting in loss of control. Hence, before turning at sharp points, first slow down the speed of the car and then take a turn.

Maintenance of tyre during monsoons: Tyre should be inspected for cuts, nicks or any damage which may lead to tyre burst and accident. Tyre pressure is to be maintained at the recommended level. Spare tyre must be in good condition and properly inflated. Do not brake suddenly. Sudden braking on a wet surface may result in skidding and overturning due to a weak grip. On wet road surface apart from controlling speed apply break slowly. Do not over-speed on wet roads. Avoid two-wheelers in the rain if possible. Those who must ride should take extra precautions. Slow down. Rain causes oil in the road to rise to the surface. Water and oil make the road both wet and slick. Also, new potholes develop following heavy rains. It may not be seen if it is waterlogged. Falling into these potholes or swerving suddenly to avoid it can cause accidents.

(The writer is Professor & Head - Nephrology, Amala Institute of Medical Sciences, Thrissur)

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